Midfacial Growth in a Consecutive Series of Preadolescent Children With Complete Unilateral Cleft Lip and Palate Following a One-Stage Simultaneous Repair

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Objective:To evaluate midfacial growth in prepubertal children with complete unilateral cleft lip and palate following one-stage simultaneous repair.Subjects:A series of 28 consecutively treated subjects with complete unilateral cleft lip and palate were compared with age- and gender-matched controls with normal midfacial structure.Methods:On the lateral cephalograms taken at the age of approximately 10 years, size and position of the maxilla and upper dental arch were evaluated in vertical and horizontal planes. Statistical analysis included independent t tests and nonparametric Mann-Whitney tests.Results:The maxilla was found to be retruded (sella-nasion-point A angle decreased by 4.5u and nasion to point A distance increased by 4.2 mm) and rotated posteriorly (sella-nasion/palatal plane angle decreased by 4.5u) in the cleft group. Maxillary length (pterygomaxillare-point A distance) was diminished by approximately 2 mm. Upper incisors were found retroclined in comparison to controls (both upper incisor axis/sella-nasion and upper incisor axis/palatal plane angles were decreased by 10.7u and 6.1u, respectively).Conclusion:Maxillary prominence, as measured with the sella-nasion-point A angle and the condylion-point A and articulare-point A distances, was decreased. Shortened length and posterior position of the maxillary body were responsible at a ratio of 60% to 40% for a decreased prominence of the maxillary complex. The palatal plane demonstrated a larger inclination to the sella-nasion plane by 4.5u due to a decreased sella-posterior nasal spine distance.

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